Analysis of influencing factors of osteoporosis in postmenopausal patients with type 2 diabetes mellitus and construction of nomogram model

Abstract

"Objective To explore the influencing factors of osteoporosis (OP) in postmenopausal patients with type 2 diabetes mellitus (T2DM), and try to establish a predictive model of nomogram in developing OP in postmenopausal patients with T2DM. Methods A total of 335 postmenopausal patients with T2DM hospitalized in the Department of Endocrinology of Shanxi Provincial People's Hospital from September 1, 2022 to September 1, 2023 were selected retrospectively as the study subjects. According to bone mineral density, the patients were divided into osteoporosis group (176 cases, 52.5%) and non-osteoporosis group (159 cases, 47.5%). Univariate analysis and logistic regression analysis were used to analyze the influencing factors of OP in postmenopausal patients with T2DM, and a nomogram prediction model of OP in postmenopausal patients with T2DM was constructed based on the latter, the receiver operating charateristics (ROC) curve was used to analyze the predictive performance of the nomogram model, and the accuracy of the nomogram model was analyzed by the calibration curve. Results Compared with the non-osteoporosis group, the osteoporosis group had older age, longer duration of diabetes, higher level of β-isomerized C-terminal telopeptides of type Ⅰ collagen (β-CTX), lower body mass index (BMI) and lower serum phosphorus level（P＜0.05）. Age (OR=1.095,P＜0.01), duration of diabetes (OR=1.055,P＜0.01), β-CTX (OR=1.003,P＜0.01), BMI (OR=0.875,P＜0.01), and serum phosphorus (OR=0.187,P=0.023) were the influencing factors of OP in postmenopausal patients with T2DM.〖JP3〗 ROC curve analysis results showed that the area under curve (AUC) of the constructed nomogram model for predicting OP in postmenopausal patients with T2DM was 0.770. The calibration curve analysis results showed that the calibration curve of the nomogram model was close to the ideal curve. Conclusion High BMI and high phosphorus are protective factors of OP in postmenopausal patients with T2DM, while old age, long duration of diabetes and high level of β-CTX are risk factors. The nomogram model based on the above influencing factors has good predictive value for OP in postmenopausal patients with T2DM."

Keywords

• postmenopausal type 2 diabetes mellitus; osteoporosis; influencing factors; β-isomerized c-terminal telopeptides of type ⅰ collagen; nomogram